Effects of sulindac and ibuprofen in patients with cirrhosis and ascites. An explanation for the renal-sparing effect of sulindac.
Effects of sulindac and ibuprofen in patients with cirrhosis and ascites. An explanation for the renal-sparing effect of sulindac.
复制标题
舒林酸和布洛芬对肝硬化腹水患者的影响。
DOI：
10.1016/0016-5085(86)90091-0
复制
发表时间：
1986
期刊：
影响因子：
29.4
通讯作者：
Zipser,RD
中科院分区：
文献类型：
--
作者：
Laffi,G;Daskalopoulos,G;Kronborg,I;Hsueh,W;Gentilini,P;Zipser,RD
非甾体类抗炎药损害肝硬化和腹水易感患者的肾功能。据报道，一种新的抗炎药舒林酸不会影响肾功能。为了评估其保肾机制，对10例患者分别给予5天的舒林达和1天的布洛芬治疗，监测对氨嘌呤和菊糖清除率、血清和尿液类二十碳酸盐以及血清和尿液舒林达代谢物。布洛芬降低了5名钠潴留最多的受试者的肾脏清除率，而舒林达没有效果。肝脏患者血浆活性硫化物代谢物浓度显著升高，且与血清血栓素抑制相关（r = 0.75, p = 0.01）。舒林酸组血清血栓素抑制率与尿二十烷抑制率相关（r = 0.68 ~ 0.81，均p < 0.02）。布洛芬通常是一种更有效的血清和尿液类二十烷酸抑制剂。因此，舒林酸肾保护作用的一个主要因素似乎是它对肾脏和肾外环加氧酶系统的抑制作用较弱。
Nonsteroidal antiinflammatory drugs impair renal function in susceptible patients with cirrhosis and ascites. A new antiinflammatory drug, sulindac, is reported not to affect renal function. To evaluate its renal-sparing mechanism, sulindac was administered for 5 days and ibuprofen for 1 day to 10 patients and paraaminohippurate and inulin clearances, serum and urine eicosanoids, and serum and urine sulindac metabolites were monitored. Ibuprofen reduced renal clearances in the 5 subjects with greatest sodium retention, whereas sulindac had no effect. Plasma concentration of the active sulfide metabolite was markedly increased in liver patients, and this concentration correlated with the inhibition of serum thromboxane (r = 0.75, p = 0.01). The percent inhibition of serum thromboxane with sulindac administration correlated with the inhibition of urinary eicosanoids (r = 0.68–0.81, all p < 0.02). Ibuprofen was generally a more potent inhibitor of serum and urine eicosanoids. Thus, a major factor in the renal-sparing effect of sulindac appears to be its less potent inhibition of renal and extrarenal cyclooxygenase systems.